Clinic Visits

Clinic Appointments

The American Diabetes Association (ADA) recommends that every 3 months anyone with diabetes should be seen by a healthcare provider who can help manage diabetes. There may be times more frequent clinic visits are suggested.

You will have a team of healthcare professionals to help manage diabetes at each clinic visit. Your team members include:

Pediatric endocrinologist – a doctor who has specialized in the medical management of children with endocrine problems, including diabetes

Mid-level practitioner – a nurse practitioner or physician assistant who gives medical care to children under the direction of a doctor

Social work – a person trained to help with barriers to healthcare and mental health issues

Diabetes clinic visits are often longer than other clinic visits. Plan on 2 hours for each visit. The visit will focus on issues specific to diabetes and the endocrine system. Your child should keep seeing a primary care doctor for regular healthcare needs. This includes well child visits and immunizations. It is also important to see a dentist every 6 months. People with diabetes are more likely to have some dental problems.

A legal guardian or an adult who has written permission from the legal guardian must come with any child under age 18 to clinic visits. If you have concerns about sensitive issues and would like to speak to a healthcare professional alone, let us know when you register for your visit.

If you need to cancel a clinic visit, let us know as soon as possible. Clinic times fill up quickly.

What to Expect

Review of growth and development. This includes height, weight, body mass index (BMI), and stage of sexual development.

Blood pressure

Hemoglobin A1C. This will be taken from a drop of blood in clinic. You will have results by the end of the clinic visit.

Review of current diabetes management. This includes blood glucose monitoring, medicine management, and nutrition.

Review of blood glucose patterns. The doctor may make changes to insulin doses if needed.

Problems or struggles you or your child may have with diabetes management.

What to expect as your child grows.

How to Get the Most Out of Your Visit

Bring completed blood glucose records, logbook, and blood glucose meter. This includes printing off the most recent downloaded meter readings.

Come ready to talk about your or your child’s health goals and the things that stand in the way of good health habits.

How to Help

Bring the pharmacy name, phone number, and address with you.

Check to see that you have enough refills to last until your next visit.

Bring the complete list of medicines your child takes.

Continuing Care for Living a Healthy Life

There are some medical problems that are more common with diabetes or after you get diabetes. The ADA recommends the following screenings, so that problems can be treated early if they do happen.

At diagnosis:

Celiac screen - Celiac disorder is an allergy to wheat. If the screen is positive, a referral to a gastrointestinal (GI) doctor will be recommended. Celiac disorder is managed by eating a gluten-free diet.

Thyroid screen – If your child has thyroid disorder, it is managed with a daily pill.

Insulin antibodies - Confirms type 1 diabetes diagnosis.

Hemoglobin A1C – Gives the average blood glucose over the last 3 months.

Once each year:

Thyroid screen

Dilated eye exam - Can find vision problems related to diabetes. Start getting this exam when the child starts puberty or is 10 years old (whichever happens first) and has had type 1 diabetes for 3 years.

Urine microalbumin – Finds any early kidney problems. Start getting this test when the child starts puberty or is 10 years old (whichever happens first) and has had type 1 diabetes for 5 years.

Lipid profile (cholesterol)- Start when the child is older than 18 years of age.

NOTE: For type 2 diabetes, dilated eye exam, lipid profile, and urine microalbumin should be done every year, starting at diagnosis or once child is 10 years old.

Once every 5 years:

Lipid profile (cholesterol) – Screening should start around puberty (around 10 years old). If there is a family history of early heart disease or high cholesterol, screening should start earlier. If the results are normal, the screen is repeated every 5 years. The doctor will decide what to do if results are abnormal.

After Clinic Visits

We can help you best when your prescription refills and form requests are done at clinic visits. We understand that you may need our help between clinic visits. Most problems can be handled during office hours by calling 614-722-4425. Office hours are 8 a.m. to 4:30 p.m., Monday through Friday.

After regular office hours call the Nationwide Children’s Hospital Operator at 614-722-2000 and ask to speak with the Endocrinologist on call. There is always a doctor on call after hours to help with urgent problems.

You will get an After Visit Summary (AVS) before leaving your clinic visit. DO NOT leave your visit until you have received your AVS. Your AVS will include the following information to help in the care of your child:

Patient Instructions

You may see recommendations from the diabetes educator, the registered dietitian, the social worker, and/or the doctor here. The information will review what they talked about with you at your clinic visit.

Plan

The plan is written by the doctor, nurse practitioner, and/or physician assistant who saw you at that visit. The plan will include:

The A1C taken at this visit. If lab work is needed, you will be sent to the lab to get this done.

The type of insulin and the amount that you need to take.

Blood glucose testing recommendations.

Other medicines your child is taking, if any.

Office contact information for any other questions or concerns, before your next clinic visit.

Your next scheduled clinic visit date, time, and place.

Cancelling Your Visit

Regular office visits are very important in good management of your child’s diabetes. There may not be many available visits to reschedule your child in a timely manner.

We know that emergencies may happen and keep you from coming to your child’s scheduled appointment. Please give us at least 24 hour notice if you cannot make your appointment. Call Nationwide Children’s Hospital Central Scheduling at 614-722-6200 to reschedule your appointment.